HomeMy WebLinkAboutBLD4944 Mobile Home - BLD Permit / Conditions - 9/15/1976 Rodgers, Raymond F. #4944
9-15-76
Hood Canal Land Improvement Addn.
loci Lots 21 through 31
Block 54 Lots 1 & 32
Mobile Home
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584 p
DATE ISSUED ///J/7
PERMIT NO.
NAME �/ MAIL ADDRESS CITY&STATE CZIIP PHON
OWNER 1 . /��y 0 �y(osT W�/ W/1C, I" Vy��
DIRECTIONS
TO JOB SITE ���/ _,1� /�(�b'�7ev v M ro�/ fi✓ Sr ?/0 d ' DI�i�/CE-
LEGAL 1 N � � a(p �7 .5/ SEE ATTACHED SHED 5
DESCR. Slyut Qvl�c' ch.
NAME MAIL ADDRESS CFP"-S*AT j�� 32 LICENSE NO. ,��,�_��PH NE
CONTRACTOR � ���� / � �yk= v
USE OF — W 2 —
BUILDING MCA
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Descri a work:
211
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
AP ICATION E ED BY PLANS CHECK BY 6:R�!�FS)R IS UANCE Type of Occupancy J Division
Const. Group
� � y
Size of Bldg. No. of Max,
(Total) Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT.
Firm PUBLIC WORKS
BY ROAD DEPT.
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be ' c nformaWtheth. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
/ IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owne Date. J YYY WORK IS COMMENCED.
PL CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH